Emphasise burns prevention in developing countries
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《英国医生杂志》
EDITOR—Ahuja et al highlight factors associated with high risk of burns injuries.1 In our experience in Nigeria, additional factors include perennial fuel scarcity, adulterated kerosene, erratic power supply, and local traditional practices such as hot water baths for mothers immediately after childbirth and the treatment of convulsions in children with fire.
As a result of fuel shortages, petrol is stored in homes and carried in overcrowded vehicles. Therefore, although most burns injuries occur in the home, burns after road traffic injuries are on the increase. Although management is based on standard principles, hospitals are ill equipped with staff and support facilities. Physiotherapy is often assisted by patients' relatives. Delays in hospital presentation are common. Ambulance and prehospital services are nonexistent. The vulnerable groups are women and children and young men with petrol burns.
The emphasis should therefore be on prevention, by advocating change from harmful cultural practices. This needs to be done with care and sensitivity. The radio has the greatest reach for this, with tips on prevention and first aid treatment aired in the local language. Similar tips in school lessons and antenatal clinic talks will create awareness among children and pregnant women. Market days provide opportunities for public enlightenment and education at village market squares. Collaborative initiatives that help train staff in burns management will be very useful. Measures such as electrification as recommended by the World Health Organization2 require sustained pressure on governments that have the resources to re-order their priorities.
Abdu S Opaluwa, locum specialist registrar general surgery
Kings Mill Hospital, Sutton in Ashfield, Nottinghamshire NG17 4JL asopaluwa@yahoo.com
Samuel K Orkar, plastic surgery registrar
Glasgow Royal Infirmary, Glasgow G4 0SF
Competing interests: Both authors worked previously at Jos University Teaching Hospital, Jos, Nigeria.
References
Ahuja RB, Bhattacharya S. Burns in the developing world and burn disasters. BMJ 2004;329: 447-9. (21 August)
World Health Organization. Burns. www.who.int/violence_injury_prevention/unintentional_injuries/burns/burns2/en/print.html (accessed 21 Aug 2004).
As a result of fuel shortages, petrol is stored in homes and carried in overcrowded vehicles. Therefore, although most burns injuries occur in the home, burns after road traffic injuries are on the increase. Although management is based on standard principles, hospitals are ill equipped with staff and support facilities. Physiotherapy is often assisted by patients' relatives. Delays in hospital presentation are common. Ambulance and prehospital services are nonexistent. The vulnerable groups are women and children and young men with petrol burns.
The emphasis should therefore be on prevention, by advocating change from harmful cultural practices. This needs to be done with care and sensitivity. The radio has the greatest reach for this, with tips on prevention and first aid treatment aired in the local language. Similar tips in school lessons and antenatal clinic talks will create awareness among children and pregnant women. Market days provide opportunities for public enlightenment and education at village market squares. Collaborative initiatives that help train staff in burns management will be very useful. Measures such as electrification as recommended by the World Health Organization2 require sustained pressure on governments that have the resources to re-order their priorities.
Abdu S Opaluwa, locum specialist registrar general surgery
Kings Mill Hospital, Sutton in Ashfield, Nottinghamshire NG17 4JL asopaluwa@yahoo.com
Samuel K Orkar, plastic surgery registrar
Glasgow Royal Infirmary, Glasgow G4 0SF
Competing interests: Both authors worked previously at Jos University Teaching Hospital, Jos, Nigeria.
References
Ahuja RB, Bhattacharya S. Burns in the developing world and burn disasters. BMJ 2004;329: 447-9. (21 August)
World Health Organization. Burns. www.who.int/violence_injury_prevention/unintentional_injuries/burns/burns2/en/print.html (accessed 21 Aug 2004).